Ken Grauer, MD
APRIL 3, 2023
I was asked for my interpretation of this tracing. No history was provided. How would YOU interpret this long lead II rhythm strip? Are the different-looking beats PVCs or supraventricular impulses conducted with aberration? — or — Something else? Figure-1: The long lead II rhythm strip for today’s case. No history was available. ( To improve visualization — I've digitized the original ECG using PMcardio ).
Pediatric EM Morsels
APRIL 7, 2023
There are many conditions that we would like to think belong only to the “ adult patient problem DDx; ” however, as we have discussed several times previously, pediatric patients can experience many “adult conditions” (see, Aortic Dissection , Kidney Stones , and Cholecystitis ). Those conditions usually have a substantial risk factor and one of the most risky of risk factors is Sickle Cell Disease !
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Mount Sinai EM
APRIL 7, 2023
Tuberculosis in the ED Patient presents to Elmhurst ED with cough, hemoptysis, night sweats and fatigue – quick, what’s the first diagnosis that comes to mind? This is the classic presentation for tuberculosis. But several times now I have been surprised by less typical symptoms of TB. So I thought it might be helpful to review how TB might present in the ED, especially since some estimates say that ⅓ of the world’s population is infected.
EMCrit
APRIL 3, 2023
(Blogitorials are short, informal blogs that are written in the spirit of a tweetorial). Stress hyperglycemia is an everyday occurence in the ICU, but we hardly know how to treat it. I've been waiting years for this topic to be clarified… but I've realized that such clarity will probably never be reached. Why? The traditional […] EMCrit Project by Josh Farkas.
RebelEM
APRIL 5, 2023
REBEL Core Cast 99.0 – Bundle Branch Blocks Click here for Direct Download of the Podcast Cardiac Conduction System (LITFL) Definition: Interruption of the normal conduction system leading to aberrant conduction and an abnormal QRS morphology Anatomy: At the AV node, conduction splits into the right and left bundle branches. The left bundle branch is composed of anterior and posterior branches.
PDC Healthcare
APRIL 4, 2023
PDC Thermal Wristbands are Lab Tested to Perform in Demanding Healthcare Environment Healthcare providers are constantly evaluating patient safety standards to improve methods to reduce medical errors. Identification plays an important role here, specifically with the use of barcode technology to ensure a patient is receiving the correct care at the correct time.
Mount Sinai EM
APRIL 7, 2023
“Take a deep breath and hold it. Now without exhaling, try to breathe in again.” We were in the cardiac room, discussing a young man that had died a few hours before we came onto our shift. He had been brought in after he was found in the subway with albuterol inhalers all around him. And Dr. Cherkas, in his infinite wisdom, was helping me understand what it’d be like to have an asthma exacerbation.
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Mind The Bleep
APRIL 2, 2023
Junior Doctors in the UK are increasingly moving to Australia after FY1, for FY3 or other years in between training. You can even join an exchange programme as part of your training to spend a year abroad. The helpful thing is that with a similar healthcare system and with so many doctors from the UK, it tends to be a really easy transition. Let’s face it – rotational training has made us specialists in moving far away to a new place and making new friends (although this distance is
Medical Law
APRIL 7, 2023
There are over 85 million dogs kept as pets in this country. Dogs provide their owners with love and companionship, and they’re a wonderful addition to many households. It’s important to remember that dogs are animals that may react violently in certain situations. But there are several things we can do to help prevent dogs from biting people. That’s why April 9 through April 15 has been declared National Dog Bite Prevention Week.
AED Leader
APRIL 7, 2023
At the 36th Bethesda Conference in 2005, a panel of cardiology experts developed guidelines restricting exercise for people with hypertrophic cardiomyopathy with the aim of reducing sudden cardiac death. Now, more recent evidence indicates that these restrictions probably didn’t reduce death rates and may have caused secondary problems associated with inactivity.
Greater Sydney Area HEMS
APRIL 6, 2023
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Dr. Smith's ECG Blog
APRIL 6, 2023
This patient presented with complications of his dialysis fistula. Medical history: History of Ischemic Heart Disease History of Congestive Heart Failure Diabetes Mellitus requiring treatment with insulin Pre-operative serum creatinine >2 mg/dL He had this ECG recorded: What do you think? There is AV 2nd degree AV Block (Mobitz I, Wenckebach) with RBBB and LAFB The physicians recognized the RBBB and LAFB, but not the Wenckebach.
Broome Docs
APRIL 6, 2023
We are back with the long-windiest and borderline funny Emergency Medicine journal club to date. Justin and I are covering some big new trials, some old and unusual papers and a few that just might change your practice. As always the links to the papers are in the write up below and you definitely should read them rather than believe a couple of nerds amusing themselves upon the internet.
American Medical Compliance
APRIL 6, 2023
In January 2023, federal investigators convicted twenty-five people in Miami as part of a scheme to get counterfeit nursing school degrees and find jobs for aspiring nurses. Associated Charges According to recently unsealed federal grand jury charges, the defendants were involved in a scam that involved the sale of more than 7,600 counterfeit nursing degree credentials from three Florida-based nursing programs.
NRC Health
APRIL 6, 2023
2023 Pediatric Experience Perspective details new data, trends, and strategies for healthcare organizations. The post 2023 Pediatric Experience Perspective details insights, trends, and strategies for healthcare organizations appeared first on NRC Health.
Taming the SRU
APRIL 5, 2023
THE CASE An elderly female patient presents to the emergency department (ED) with 1 week of generalized weakness leading to numerous falls. She denies any fevers, abdominal pain, nausea, or vomiting. She has a history of previous episodes of nephrolithiasis, frequent urinary tract infections, and states she takes gabapentin for overactive bladder. She denies any current dysuria or hematuria.
Life in the Fast Lane
APRIL 5, 2023
Andrew Davies Mastering Intensive Care 078 with Chris Nickson Modern & innovative clinician education.
PDC Healthcare
APRIL 4, 2023
PDC Thermal Wristbands are Lab Tested to Perform in Demanding Healthcare Environment Healthcare providers are constantly evaluating patient safety standards to improve methods to reduce medical errors. Identification plays an important role here, specifically with the use of barcode technology to ensure a patient is receiving the correct care at the correct time.
ECG Guru
APRIL 4, 2023
The Patient: This series of ECGs is from a 65-year-old woman who was complaining of a sudden onset of chest pain, nausea, and weakness. She stated that the pain increased on inspiration. She reported a history of non-insulin-dependent diabetes mellitus (NIDDM). ECG No. 1, 14:46: This ECG includes V4Right, V8 and V9 in place of V4, V5, and V6.
Dr. Smith's ECG Blog
APRIL 4, 2023
Submitted by Dr. Dennis Cho (@DennisCho), written by Jesse McLaren A 70-year-old with no cardiac history presented with 2 hours of chest pain radiating to the neck, associated with shortness of breath. What do you think? There’s normal sinus rhythm, first-degree AV block, normal axis and voltages. R wave progression is abnormal: there are Q waves in aVL/V2-3 and loss of R wave in V2.
Canadian EM
APRIL 4, 2023
Although some COVID-19 survivors report persistent symptoms months after resolution of the acute infection, we do not know much about their long-term physical and psychological health outcomes. We sought to understand which patient factors are associated with poor patient-reported health outcomes to inform the development and prioritization of health interventions to improve the health of COVID-19 survivors.1 We used data from 22 CCEDRRN EDs across 5 provinces between March 2020 to July 2021.
NRC Health
APRIL 4, 2023
At HUB23, you’ll find expanded, dynamic programming focused on bringing impact to your organization. The post Human Understanding Beyond | HUB23 Preview: “Elevating Experience” appeared first on NRC Health.
EMergucate
APRIL 3, 2023
The following chest x-ray is from a critically unwell patient. What can be seen? Answer will be posted later.
Life in the Fast Lane
APRIL 2, 2023
Hayden Richards Comms Lab: SCARF Comms Lab 46: SCARF: The Greatest Communication Tool You've Never Heard Of.? A brained based model for understanding and managing conflict.
Dr. Smith's ECG Blog
APRIL 2, 2023
I was reading EKGs on the system and came across this one. I am always looking for EKGs that show either subtle OMI or OMI mimics. Which did I think this was? I suspected that this was a mimic. It is hard to say why. There is "inferior" ST depression, reciprocal to high lateral ST Elevation. The precordial leads have ST Elevation but also high voltage and look like possible LVH.
Dr. Wes
APRIL 2, 2023
With the ongoing forcing of participation in Maintenance of Certification (MOC) of US physicians by the American Board of Medical Specialties (ABMS)and its 24 member boards, we are seeing the slow demise of physician-selected Continuing Medical Education (CME) in America. Attendance at specialty society meetings is at an all-time low.
EMergucate
APRIL 2, 2023
The chest X-ray shows. Right upper lobe collapse.
Board Bombs
APRIL 2, 2023
What if we told you there was a type of stroke that affected young people, caused more seizures than "typical arterial strokes", and the typical ED imaging does not diagnose it. Scared yet? You should be. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com.
JournalFeed
APRIL 1, 2023
The JournalFeed podcast for the week of March 27-30, 2023. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Yes Flu, No Abx Spoon Feed Patients at two separate urgent care locations—one with rapid influenza diagnostic testing (RIDT) and one without—were compared on several parameters.
University of Maryland Department of Emergency Med
APRIL 7, 2023
Acute lower back pain is a very common emergency department presenting complaint. Over the last several years there has been impetus to.
EMergucate
APRIL 2, 2023
The pelvic X-ray shows. Ischial tuberosity avulsion fracture on the left side. This is due to hamstring pull.
Dr. Smith's ECG Blog
APRIL 7, 2023
There are 4 quizzes here on OMI ECG diagnosis: Beginner Novice Intermediate Advanced The first link on the page is to an ECG guide as a primer on OMI ECG diagnosis. These quizzes were written by Gregory Yates (an "FY 2 doctor" in the UK), Maddy Kahle (who is just finishing her 4th year of medical school at the U of MN), and aided by Romi Lee (another U of MN med student).
Greater Sydney Area HEMS
APRIL 5, 2023
In infants, a blood pressure cuff can be used as an effective pelvic splint. Post-RSI sedation in paediatrics is cognitively challenging. Take the time to sense-check the dosing strategy you are using. The NETS calculator might be a useful resource if you are looking for one…but get familiar prior to using it on a job. Suspension trauma leads to orthostatic cardiac arrest – lots of case reports of patients dying after climbing accidents where they are suspended, but without apparent
University of Maryland Department of Emergency Med
APRIL 6, 2023
Background: Intranasal dexmedetomidine has seen usage in the anesthesia and sedation realms over the past few years, with an increasing interest in usage in t.
Taming the SRU
APRIL 3, 2023
Resuscitative hysterotomy - brash syndrome - R4 Capstone - HIV Screening in the ED R3 Taming the sru: resuscitative hysterotomy w/ Dr. stark Indications: Maternal cardiac arrest > 20 weeks (at or above umbilicus) Ideally, perform within 4 minutes of arrest One study showed that this may be able to be extended to 10 minutes Increases maternal cardiac output by 30% No studies have proven improved maternal survival Procedure: Incision from umbilicus to pubic symphysis Expose the uterus and retr
EMergucate
APRIL 3, 2023
Answers: Question 1: pH 7.62 that is moderate to severe alkalaemia HCO3 36mmol/L, so we have metabolic alkalosis.
Pediatric Education
APRIL 2, 2023
Patient Presentation A 6-month-old male came to clinic for his health supervision visit. He had been relatively well except for one ear infection and two upper respiratory infections since starting childcare. His mother was concerned about also giving influenza and COVID vaccines in addition to his regular vaccines. The pertinent physical exam showed a healthy, smiling infant with growth parameters at the 10% for height and 50% for weight and head circumference.
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